Clown Pediatrics

LBN: Clown Pediatrics
Clown Pediatrics is an health care organization with primary practice located at 401 Camby Ct , Greenwood IN 46142-4085. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Clown Pediatrics can be contacted via phone (317) 881-8737, or through Roscoe, Jeremy Wade via phone (317) 881-8737.

Contact Information

Primary practice address
401 Camby Ct Greenwood IN 46142-4085
Phone: (317) 881-8737
Fax: (317) 881-8735
Website:
Map and Directions
Authorized official contact:
Name: Roscoe, Jeremy Wade Doctor of Medicine (MD)
Phone: (317) 881-8737

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1057187 A Indiana

Profile Details

NPI number 1669674461
LBN Legal business name Clown Pediatrics
DBA Doing business as
Authorized official Roscoe, Jeremy Wade Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 4th, 2007
Last updated May 9th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669674461 NPPES
Indiana MEDICAID 200479420 A

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